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  6. 2024 ICD-10-CM Code S42.35
Version 2024
Non-Billable Code

2024 ICD-10-CM Diagnosis Code S42.35

Comminuted fracture of shaft of humerus

ICD-10-CM Code:
S42.35
ICD-10 Code for:
Comminuted fracture of shaft of humerus
Is Billable?
Not Valid for Submission
Code Navigator:

Code Classification

  • Injury, poisoning and certain other consequences of external causes
    (S00–T88)
    • Injuries to the shoulder and upper arm
      (S40-S49)
      • Fracture of shoulder and upper arm
        (S42)

S42.35 is a non-specific and non-billable diagnosis code code, consider using a code with a higher level of specificity for a diagnosis of comminuted fracture of shaft of humerus. The code is not specific and is NOT valid for the year 2024 for the submission of HIPAA-covered transactions. Category or Header define the heading of a category of codes that may be further subdivided by the use of 4th, 5th, 6th or 7th characters.

Specific Coding Applicable to Comminuted fracture of shaft of humerus

Non-specific codes like S42.35 require more digits to indicate the appropriate level of specificity. Consider using any of the following ICD-10-CM codes with a higher level of specificity when coding for comminuted fracture of shaft of humerus:

  • S42.351 for Displaced comminuted fracture of shaft of humerus, right arm - NON-BILLABLE CODE

  • Use S42.351A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.351B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.351D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.351G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.351K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.351P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.351S for sequela - BILLABLE CODE

  • S42.352 for Displaced comminuted fracture of shaft of humerus, left arm - NON-BILLABLE CODE

  • Use S42.352A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.352B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.352D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.352G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.352K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.352P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.352S for sequela - BILLABLE CODE

  • S42.353 for Displaced comminuted fracture of shaft of humerus, unspecified arm - NON-BILLABLE CODE

  • Use S42.353A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.353B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.353D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.353G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.353K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.353P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.353S for sequela - BILLABLE CODE

  • S42.354 for Nondisplaced comminuted fracture of shaft of humerus, right arm - NON-BILLABLE CODE

  • Use S42.354A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.354B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.354D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.354G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.354K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.354P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.354S for sequela - BILLABLE CODE

  • S42.355 for Nondisplaced comminuted fracture of shaft of humerus, left arm - NON-BILLABLE CODE

  • Use S42.355A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.355B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.355D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.355G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.355K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.355P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.355S for sequela - BILLABLE CODE

  • S42.356 for Nondisplaced comminuted fracture of shaft of humerus, unspecified arm - NON-BILLABLE CODE

  • Use S42.356A for initial encounter for closed fracture - BILLABLE CODE

  • Use S42.356B for initial encounter for open fracture - BILLABLE CODE

  • Use S42.356D for subsequent encounter for fracture with routine healing - BILLABLE CODE

  • Use S42.356G for subsequent encounter for fracture with delayed healing - BILLABLE CODE

  • Use S42.356K for subsequent encounter for fracture with nonunion - BILLABLE CODE

  • Use S42.356P for subsequent encounter for fracture with malunion - BILLABLE CODE

  • Use S42.356S for sequela - BILLABLE CODE

Coding Guidelines

The principles of multiple coding of injuries should be followed in coding fractures. Fractures of specified sites are coded individually by site nd the level of detail furnished by medical record content.

A fracture not indicated as open or closed should be coded to closed. A fracture not indicated whether displaced or not displaced should be coded to displaced.

Initial vs. Subsequent Encounter for Fractures

Traumatic fractures are coded using the appropriate 7th character for initial encounter (A, B, C) for each encounter where the patient is receiving active treatment for the fracture. The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.

Fractures are coded using the appropriate 7th character for subsequent care for encounters after the patient has completed active treatment of the fracture and is receiving routine care for the fracture during the healing or recovery phase.

Care for complications of surgical treatment for fracture repairs during the healing or recovery phase should be coded with the appropriate complication codes.

Care of complications of fractures, such as malunion and nonunion, should be reported with the appropriate 7th character for subsequent care with nonunion (K, M, N,) or subsequent care with malunion (P, Q, R).

Malunion/nonunion: The appropriate 7th character for initial encounter should also be assigned for a patient who delayed seeking treatment for the fracture or nonunion.

The open fracture designations in the assignment of the 7th character for fractures of the forearm, femur and lower leg, including ankle are based on the Gustilo open fracture classification. When the Gustilo classification type is not specified for an open fracture, the 7th character for open fracture type I or II should be assigned (B, E, H, M, Q).

Index to Diseases and Injuries References

The following annotation back-references for this diagnosis code are found in the injuries and diseases index. The Index to Diseases and Injuries is an alphabetical listing of medical terms, with each term mapped to one or more ICD-10-CM code(s).

Patient Education


Arm Injuries and Disorders

Of the 206 bones in your body, three of them are in your arm: the humerus, radius, and ulna. Your arms are also made up of muscles, joints, tendons, and other connective tissue. Injuries to any of these parts of the arm can occur during sports, a fall, or an accident.

Types of arm injuries include :

  • Tendinitis and bursitis
  • Sprains
  • Dislocations
  • Fractures (broken bones)
  • Nerve problems
  • Osteoarthritis

You may also have problems or injure specific parts of your arm, such as your hand, wrist, elbow, or shoulder.


[Learn More in MedlinePlus]

Fractures

A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open or compound fracture. Fractures commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the bone.

Symptoms of a fracture are:

  • Intense pain
  • Deformity - the limb looks out of place
  • Swelling, bruising, or tenderness around the injury
  • Numbness and tingling
  • Problems moving a limb

You need to get medical care right away for any fracture. An x-ray can tell if your bone is broken. You may need to wear a cast or splint. Sometimes you need surgery to put in plates, pins or screws to keep the bone in place.


[Learn More in MedlinePlus]

Code History

  • FY 2024 - No Change, effective from 10/1/2023 through 9/30/2024
  • FY 2023 - No Change, effective from 10/1/2022 through 9/30/2023
  • FY 2022 - No Change, effective from 10/1/2021 through 9/30/2022
  • FY 2021 - No Change, effective from 10/1/2020 through 9/30/2021
  • FY 2020 - No Change, effective from 10/1/2019 through 9/30/2020
  • FY 2019 - No Change, effective from 10/1/2018 through 9/30/2019
  • FY 2018 - No Change, effective from 10/1/2017 through 9/30/2018
  • FY 2017 - No Change, effective from 10/1/2016 through 9/30/2017
  • FY 2016 - New Code, effective from 10/1/2015 through 9/30/2016. This was the first year ICD-10-CM was implemented into the HIPAA code set.